Healthcare Provider Details

I. General information

NPI: 1164453320
Provider Name (Legal Business Name): GABRIEL G. CARABELLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E CESAR E CHAVEZ AVE STE. 2450
LOS ANGELES CA
90033-2424
US

IV. Provider business mailing address

1826 CALLE FORTUNA
GLENDALE CA
91208-3023
US

V. Phone/Fax

Practice location:
  • Phone: 323-265-4559
  • Fax: 323-265-4570
Mailing address:
  • Phone: 213-700-4294
  • Fax: 323-265-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG69726
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberG69726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: